The unabridged story

Dear family and friends,

Below you will find the full story of my miscarriage - including all of the very explicit details as well as a photograph of my gestational sac and placenta. Do not feel as though you need to read the full story and you have been warned about the photograph. What you need to know is that I took a drug called cytotec to induce the miscarriage so that it wouldn't occur while I was traveling on a train or plane. I asked a dear friend her miscarriage story and she told me her unabridged story and for that I am so thankful. Her story clued me in to the need to have this process happen in the comfort of my own home (or in an AirBNB in Spain). I took the drug around 3pm on December 3 and the miscarriage occurred just before midnight. I felt immediate relief after passing the placenta and gestational sac and am feeling better and better each day. We are so thankful for all of the support and I in turn hope that if someone comes searching for what might happen to them if they are experiencing a miscarriage, that this full story can help them prepare for what is to come. Some may think that the photograph is taking it a bit too far but I had no idea what to expect and I was shocked when it happened so I hope all of this can provide help and support to other women. 

We are so excited to be headed home this Saturday and are currently in London with one of my dearest friends - Jessica and her husband and sweet girls as well as her brother Jonathan aka Scruff. We are having a wonderful time and soaking up the friend love. 

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The full story:

On December 3, Jason and I went to the maternity hospital in Malaga, Spain. There was no indication that I was going to have a natural miscarriage any time soon and as I said above, I am so thankful for being encouraged to take action before traveling around the world. At the hospital, the doctor confirmed (again) with an ultrasound that there was not a heartbeat and explained our options - waiting for it to naturally occur, having a D&C (where they put you under anesthesia and scrape out the inside of your uterus), or taking cytotec which will cause the body to abort the baby. I really just wanted it over and went in knowing my options and wanting to have a D&C. The doctor said that it is much better on the body to do it naturally via cytotec so we decided to go that route. All he said was that it would take a few hours for the drug to kick in and that it would be like a heavy period. So we left the hospital and headed back to our AirBnb apartment to get the process started. I had done some reading on what to expect and how to prepare myself with supplies such as pain reliever, hot water bottle and pads ect. Jason went out and got a pizza (for later) and some "Gatorade" and we felt as ready as we could be. Here is the timeline:

15:15 - Took the cytotec vaginally. The doctor instructed me to wet the pills before inserting them - so I did that and we sat down to watch a movie and wait.

15:45 - I took a pain pill given to me by my doctor in Prague. I had read to make sure to stay on top of taking pain meds so that the pain didn't become overwhelming. 

16:00 - I started to experience slight cramps - similar to when I first start my period.

17:00 - Very faint brown spotting, slightly more intense cramps and nausea.

18:00 - Cramps ramping up to full pain period cramps. No more spotting and no blood at all. I did however poop a lot. I think my body was getting ready.

18:45 - Cramps were debilitating. I was moaning out loud for about an hour. There was nothing I could do to relieve the pain. I tried sitting on the toilet, walking around, rocking back and forth, using the hot water bottle, breathing though the pain and into the pain (I could hardly take a full breath and felt like I was hyperventilating) Jason tried to massage my back, hold my hand, I listened to loud rhythmic music -- NOTHING worked. I told Jason that I didn't think I could do it. I wanted to go to the hospital but there was no way I could make the trip.

19:50 - While moaning on the couch, my mouth filled with saliva and I sprinted toward the toilet and violently threw up. Jason says that I wasn't able to take a breath for about a minute because I was uncontrollably vomiting. He might have been a little worried at that point. From there, the constant contractions let up and I had a break of a minute or two in between contractions.  Even though the period cramps were still there between the contractions, I actually dozed off between contractions - I was exhausted.

20:30 - Jason convinced me to take some Aleve. I am afraid of drugs and was afraid to mix the medicine that my doc gave me (which did absolutely NOTHING) with Aleve. But Jason persisted and I needed pain relief. 

21:30 - Contractions were few and far between and the cramps were like heavy period cramps. We decided to resume our movie to take my mind off of the pain.

22:00 - First gush of blood and clots.

22:45 - Heavy cramps continue, no more blood.

23:15 - Ate a piece of pizza as I felt completely depleted. Just after it felt like my vagina was going to split open (different from the uterine contractions).

23:45 - Pain in vagina was intense and sitting on the toilet seemed to help. Thick blood started pouring out as well as clots of blood. Something white came out - turned out to be one of the cytotec pills. More blood but not as much as I expected and then there was a loud plop in the toilet. I fished out the mass and it was a clump of tissue and the gestational sac. Before this, I kept looking to see if I could discern what was what but this was obviously the gestational sac. It was a clear/grayish fluid filled sac and the embryo could be seen floating in the fluid as well as a clump of tissue attached - I assume placenta. I immediately felt better. The pain lessened and from there it was mostly like a normal period. I did wear a Depends to sleep in because I was still expecting more blood and I didn't want to bleed everywhere. AND this was nothing like a heavy period. I had a mini labor and I assume that taking cytotec is somewhat like taking pitocin to induce labor - where the pain comes on fast and furious. I wish that I had stronger pain meds or some natural breathing techniques to deal with the pain.

Over the next 48 hrs I passed more tissue and experienced more intense pain around that time. Occasionally I would randomly have intense contractions. In general, I would say that my uterus felt like someone had drop kicked it. I experienced some pain while peeing and pooping  for the next few days and had really bad intestinal cramps. 

On Sunday I went back to the hospital to confirm that everything had passed and indeed it had. I bled for a total of 6 days and still continue to spot although it is hardly noticeable now. It was a crazy experience and although I felt like I was prepared - I don't think anything could have really prepared me for that experience. Jason, as always, was so supportive and took such good care of me. This process has been extremely hard on us but fortunately, it has brought us closer together and I really couldn't wish for a better husband. We have a plan moving forward but I will save that for another blog post. Much love.  

*************************WARNING, graphic photo below*****************************

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No easy way to say this...

We went in for an ultrasound this morning where we discovered that fetal growth stopped about 10 days ago and there was no longer a heartbeat - it is called a missed miscarriage.. We are devastated. We have decided to allow the miscarriage to happen naturally.  I will discontinue taking all of my medications and that should clue my body in on what has happened - may take a few days, may take a week or more. Thank you for all of the love and support we have received through this process. That is all I have for now.

Heartbeat

I will start by saying that we got to see the heartbeat today!! But now I am going to back-track on the hardest 4 days ever.

On Monday we went in for our first ultrasound at 6 weeks and 1 day. The doctor was able to see one gestational sac and a yolk sac. He said that he expected to see more at this point (fetal pole and heartbeat) and suggested that it was probably a blighted ovum with a missed miscarriage. Cue the water works. WHAT!?! Basically he believed that after implantation the babe didn't develop. He discussed the options suggesting we could have a d&c (where they scrape put the inside of your uterus) vs medications vs natural.  He made us an appointment for a follow-up ultrasound at his private clinic for Friday (6 weeks 5 days) to determine if there was any growth. So, from Monday afternoon until Friday afternoon we had no idea what was happening. Was I still pregnant? Yes, I hadn't miscarried but was the babe still growing? I wanted so bad to believe but I was terrified of what the doctor discussed. After much research, I discovered that at the 6 week stage there is a large range of what can been seen. Often just a few days makes a big difference. I also experienced some major anger at the doctor suggesting this so early on as technically a blighted ovum can't be officially diagnosed until the gestational sac has reached 25mm and then a week after that if an ultrasound shows no growth. I was nowhere close to that. BUT with IVF dates and such are more certain so I get that he expected to see more. Not to mention that dating protocols can differ greatly in the first few weeks depending on who you ask.

The babe is rapidly changing as we found out today. Babe measured 4mm about the size of a sweet pea! The dating the doctor gave was 6 weeks 1 day - so about 4 days behind schedule BUT other medical sites have suggested that this is right on target. He also mentioned that the yolk sac is slightly large at 5mm and again this value is right on the border. The most important thing is that we saw and HEARD the heartbeat!! Really really amazing. We have another ultrasound scheduled for November 30 and at that point I'll be 9 weeks and 1 day. 

The black space below  is the gestational sac and the round part is the 

yolk sac and where the arrow is pointing is the babe!

I have experienced all sorts of symptoms... they come and go. I have the nose of a bloodhound and some pretty strong food aversions. I have been really tired and dizzy. And man, my boobs HURT!! I have had waves of nausea but nothing too bad but my gas is horrid!! Honestly, I'll take all the symptoms because they mean I am pregnant!! 

xo - katherine

Jsme těhotná is Czech for WE ARE PREGNANT!!

Let me back track a bit. I usually spot before my period and on Thursday I had a little spotting so I thought that I was out for this cycle but then it went away. Friday, riding the public transport felt like bring your worst smells with you day. Saturday, I woke up at 7am and took the pregnancy test and I didn't see a line right away - already feeling defeated because of the spotting, my heart sank. After I finished in the bathroom, I looked again and there was a faint line. WHAT!? Jason was still sleeping so I crawled back upstairs and said I need you to look at this because I think there is a line. He was groggy but I turned the lights on anyway and he said the line isn't as dark as the other one and that I should wait until tomorrow to test again. PSHA!! I ran downstairs and took the other pregnancy test and it was immediately positive!! I showed Jason and he agreed that it was definitely positive. And then I cried. Like sobbed. And Jason asked if they were happy tears (because although he didn't say it, I was ugly crying.) Once the tears ran out, I was in shock. This was the moment we have been waiting for but I wasn't quite sure I could believe it. We called the doctors office and went in for a blood test at 10am - it was Saturday but the nurse said that she would rush it so we could find out later that day. At 3pm she called and said the blood test is positive (I'M PREGNANT!!) and my hCG was at 107 (which is good because it was only 8 days after the transfer of our 2, 5-day old frosties) 

Now in a normal pregnancy, that would be it until your first ultrasound at around 10 weeks or so but with IVF they usually check your beta (hCG) a few times to me make sure your numbers are doubling properly. So within 48-72hrs the beta should at least double. This morning (48hrs after the first blood test) we went in and had my blood drawn again. The nurse called us an hour ago and said my hCG was at 462!! What a relief!! I am not sure that I'm going to feel safe for awhile - usually people wait to announce pregnancies after they are past 12 weeks due to miscarriage rates being higher before then but as we have been blogging, we can't and don't want to keep this a secret. WE ARE REALLY PREGNANT!! I really am in shock still. I keep announcing to Jason every so often that I am pregnant. And he has decided to start calling me "baby mama" - it is so silly but I don't care. So far, other than most things smelling bad, the other symptoms I have are sore boobs (ouch!!), feeling queasy, and one bout of vertigo and general dizziness. The vertigo happened on Sunday morning and I thought Jason was lifting the mattress and dumping me out of bed like a dump truck would do. I woke him up because I was yelling whoa! whoa!! Glad I haven't had that again!! But I'll take the slew of crazy pregnancy symptoms because it just confirms the pregnancy!!

From the bottom of our hearts, thank you so much for your support through this whole process. It has been a long road and while it has been hard sharing all of our struggles, I am happy to share some joy. We will keep posting updates as we will go in for an ultrasound in a few weeks to find out how many babies are in there! We'll be thrilled with one, two or three!! Estimated due date: July 3, 2016.

So much love - katherine

Try to be pregnant this time

As of this morning, we had 3 frozen embryos and the doctor suggested we select the best 2 for a FET (frozen embryo transfer) and those are the two from my eggs. This morning I called at 8am to see if both made it through the thaw. The woman I talked to on the phone said call back at 9am and we will know then. Know what?! I tried to get her to explain why we needed to wait an hour -- were they not looking good?? I waited for the English speaking embryologist and she said she was about to thaw them now so we would know in a hour. Whew!! At 9am I called and she said both looked good after the thaw and to come in at 10:30am. Yay!!!!!  This is an non-stimulation cycle but not to worry I still have plenty of drugs to take. They decided to hit me with all of the drugs this cycle to help my chances of becoming pregnant. I've been taking Prednisone once a day -- it is meant to help the body accept the embryo and not fight it off as if it were an intruder. I did a trigger shot Saturday night to induce ovulation (which occurs 36 hrs after the shot) so they would know when I ovulated because they want the FET to occur 5 days after ovulation. Now I have started taking the max dose of progesterone as well as added estrogen 3x/d. After the transfer, I will have daily injections of Fraxaparine, a blood thinner, that should help to prevent any clotting. The transfer went smoothly this morning and the doctor said to me -- try to be pregnant this time. It was very sweet and funny because of her word choice. She also printed an ultrasound picture after the transfer and said, now come back in 3 weeks and get another one! I want to say that I feel really hopeful (and part of me is) but also I am scared that this is not going to work but I am doing my best to stay positive. We keep joking that we could end up with triplets as we transferred 2 frosties and we also tried the old fashioned way this cycle as the egg wasn't collected after ovulation. Now THAT would be crazy!!

Our two blastocysts before transfer.

The red circle is where the 2 blastocysts are located (the bright white spot). See larger picture below.

The darker circle is my uterus/ uterine lining. And the bright white dot is where they are located. The white color is the media and air from placing them.

In other news, we are still torturing ourselves with the autoimmune diet and as an added bonus, we've both lost weight -- Jason lost 10 lbs since starting the diet (a total of 25 lbs since leaving home!!) and I've lost 8 lbs. Get ready for TMI -- although all the drugs are making me constipated so it should be more... We cheated a bit on my birthday and today for lunch because we didn't want to break our transfer ritual of eating french fries. Man were they yummy!!! Jason has been looking for jobs and has a promising lead in GJ. We miss our family and friends and would really love to go back to GJ. I found a house that I fell in love with and our friend Val went and looked at it for us while we FaceTimed her. It's tiny and adorable and perfect for us to start a family in but we didn't get it. I was pretty devastated - still am. It's hard to explain, but that house gave me something to look forward to. I could see Jason and I living there and our day to day life. The current owners have a child so the 2nd bedroom is set up for a nursery. It gave me something I could be excited for regardless of our outcome here. I keep hoping that somehow that house can be ours. We have a back-up contract in place so if anything happens with the first one then we could get it but it is unlikely. I've looked at other houses but nothing calls to me like that one and definitely not enough to put in an offer while not actually being there. I will say that I had been in the house a few years ago so I had a general feeling of what it was like. Speaking of coming home, we booked our tickets for our return and arrive the evening of December 14!! 

For now, I am taking it easy after the transfer. Keeping my feet warm (warm feet = warm uterus) and planning to eat a whole pineapple over the next 5 days (core and all). There is something in the pineapple that is suppose to help with implantation. I am willing to try anything!! For real. We are still soliciting love, well wishes, lighting of the candles, prayers and any other goodness you can send our way.

xo - katherine

Take #5

Another failed cycle. The emotions are overwhelming. I've, for the most part, been pulling back from everyone because I just don't want to feel what I am feeling. Jason gets to see the full range of emotions and it is probably not fair to him for me to be closing myself off from my friends and family.  It feels like he is the only one that really understands because he is going through it too (although logically I know that many people can relate even if they have never been though this themselves). At the same time, I just want to go home. I want to go back to the way things were. I want to see my friends, go for bike rides, go to book club, have dinner with the family. I want to have my job back and have a purpose. I want to walk Willie Nelson and have him snuggle with me on the couch. We came here saying - well, if it doesn't work , then at least we'll have an amazing experience. That has been true. We have had an amazing experience but currently my will to go explore has been less and less. I just want to go home.

Despite wanting to go home, I want more to have a baby. So I am taking control of what I can in my life. Here are a few ways I feel like I can. I have a few autoimmune issues and I am wondering if that might be one of the reasons that I haven't gotten pregnant. Autoimmune issues are complex and I'm not even going to pretend to understand how it all works but there is some suggestion that diet plays into autoimmune disease - and that I can control. I found a great website that explains the Auto Immune Protocol. The following explanation is from her website. It is basically paleo eating so no grains, no legumes, no dairy, no refined sugars, no modern vegetable oils, no processed food chemicals. A few other important factors are avoiding excessive salt, refined sugars, too many carbohydrates (but this doesn’t need to be a low carb diet!) and also trying to balance omega-3 vs. omega-6 fatty acid intake. But in addition, for the autoimmune protocol, I will completely avoid:

Eggs (especially the whites)
Nuts
Seeds (including cocoa, coffee and seed-based spices)
Nightshades (potatoes, tomatoes, eggplants, sweet and hot peppers, cayenne, red pepper, tomatillos, goji berries etc. and spices derived from peppers, including paprika)
Potential Gluten Cross-Reactive Foods
Fructose consumption in excess of 20g per day
Alcohol
NSAIDS (like aspirin or ibuprofen)
Non-nutritive sweeteners (yes, all of them, even stevia)
Emulsifiers, thickeners, and other food additives

Now I am sure that many of you are thinking this is a bunch of BS but I don't really care. It makes me feel like I am DOING something. And maybe, just maybe, it will help. In addition, I asked my doctor about having my Natural Killer cells (NK cells) tested to see if they are elevated. If they are then it is possible that my body is attacking the embryo -which would prevent implantation. I am not sure how to override this (if that is what is happening) but as it is related to autoimmune issues hopefully the change in diet will help the issue.

If you have any recipes to send me please do!! I am sure that I will get so bored eating this way. The hardest part will be the nightshades. I LOVE tomatoes and spicy peppers and not having those is going to suck. That and no more chocolate croissants. Boohoo.

So what else do people do when they feel like they have no control in their lives..... they cut their hair!! I haven't done it yet but I am planning to in the next week. I am thinking shoulder length hair and maybe some side bangs or something? Any thoughts? Send pics!! Seriously. I am doing it soon.

Ok, so the other way in which we are taking control is by lining up a donor for eggs. The one donor blastocyst that we currently have frozen was from a donor oocyte that was thawed and fertilized with Jason's sperm. This is not usually how it is done. Normally, they find a donor that matches the selected criteria (blood type, height, weight, ect.) and then she goes on the stimulation medications. All of the mature eggs retrieved from her are then fertilized with Jason's sperm and from there the process is the same (and usually there are a lot more to freeze for future cycles). I imagine that will happen for the following cycle. For this cycle, we will thaw one of the eggs I produced and the one from the donor. (We ended up having 2 eggs I produced frozen as an additional egg caught up and was good enough to freeze (yay)) If those both survive the thawing process we'll go with those two, if not then we will thaw the third one that I produced and hopefully transfer that one.

So that is the update. I am so thankful for all the messages, emails, and FaceTime calls we've received. I have been a bad friend and sister and am going to make an effort to reach out more. It is difficult because I want to reach out and I think I might explode all at the same time.

This is a picture of a dog at a shop in Rome. It makes me happy.

xo - katherine

Feeling hopeful.

Just to recap what we learned on Tuesday - there were 8 fertilized embryos from my eggs and 4 fertilized donor embryos. On Thursday (day 3 of embryonic development) we called and were told that all 12 of the embryos were either a Grade 1 or 2. Fabulous news. Friday they told us that quite a few had not made it and that a few were slow growing. All in all we had a total of 4 embryos - 3 were from my eggs and one was from the donor. The 2 best looking embryos were from my eggs and they were a Grade 1 and the other 2 (one from my eggs and the one donor were Grade 2). The rest they said they would keep in the growth medium and see if they might catch up. We expected that they all wouldn't make it as it is common for about only 1/3 of embryos to make it to the blastocyst stage. But the good news is that those that do make it are far more likely to result in a live birth.

This morning the numbers were the same but they were now blastocysts and were told to come in at 11:45 for the transfer. How exciting!! We decided to use embryo glue and assisted hatching for this cycle in hope of improving our chances. Now the next question was which blastocyst(s) to transfer? We already knew that we wanted to transfer 2 and at the suggestion of the embryologist, we decided to transfer the two Grade 1 embryos. We were warned that this might result in twins... (are some people surprised when they have twins after transferring two embryos?) The other two blastocysts will be frozen for the possibility of a future cycle.

Usually Jason has to wait in the room while I go for the transfer but this time he got to go with me. Our doctor came back from Moravia early so that he could do our transfer and we were the last transfer for the day so he invited Jason to come see the procedure. This was really special for us as that meant he got to hold my hand and see the blastocysts on the screen before they were transferred.

This is not the best picture of our two blastocysts but there they are!

We are feeling very hopeful for this cycle so keep lighting candles and sending love our way!!

xo- katherine